In 2013 I entered the CBC’s Creative Nonfiction writing competition. Unfortunately, I didn’t win the contest but I wanted to share my piece, which deals with my sister’s brain injury. My submission is called Broken.

Broken

“I’m not crazy, am I Mom?” Lori asked.

“No. Now be quiet,” Mom replied, looking over my sister’s head to make eye contact with me.

“I’m blind, Mom,” Lori said. “I’m so scared. I’m not crazy, am I Mom?” My sister sipped her coffee, then slammed down the cup on the table, drops spraying across the green plastic tablecloth. “I’m not crazy, am I Mom?” Lori’s voice was tight, her words frantic and hurried. “I’m blind, Mom”.

It was Mother’s Day 2011 and I had come to my hometown to visit. I rarely went to Owen Sound between November and April because there was too much snow so I hadn’t seen my sister since Christmas. Now I could see something was wrong with her. Very wrong.

My brother and I took Lori to the local hospital the next day. The mental health emergency assessment representative, a female social worker, wanted to know if Lori had been mentally challenged all her life. “She’s not mentally challenged,” I insisted. “She’s normal. She used to be married and owned a home. She took care of my three daughters when they were little.”

This seemed to surprise the social worker and she looked at me as if I were the worst mother in the world. We went through a litany of questions and ruled out narcotics, alcohol and unusual interactions with Lori’s prescription medications. Nothing obvious jumped out as the cause of Lori’s mental distress.

“She had two corneal transplants last year, one in each eye,” I explained. “They take a long time to heal. The specialist told her she would have blurry vision in the meantime but now she has cataracts too and they won’t operate because her eyes are so fragile. She can only see shadows and some bright colours.”

“Any other medical things you can think of?”

“She had a stroke about four years ago. I’ve seen subtle changes in her over the past couple of years, like her smile isn’t quite right anymore. When you see pictures of her, things are just different. Could it be damage from the stroke?”

The woman jotted down notes and shook her head. “Probably not.”

Lori was fretting when we left her at the hospital, taking tiny circling steps, her scrawny arms curled up like the wings of a baby bird that had just hatched, shivering, eyes closed. Unable to see. I went home and cried for my own loss. The sister I knew was gone.

Three weeks on the psychiatric ward and the official diagnosis was Adjustment Disorder. She simply couldn’t cope with the loss of her sight. I was furious when I went online and read that Adjustment Disorder was such a vague and all-encompassing diagnosis as to be virtually meaningless. I pushed the nurses for more information and met with the psychiatrist to convince him to do more testing. The results from the MRI he ordered showed nothing remarkable beyond the hydrocephalus she had had for decades.

Lori had suffered a traumatic head injury at 23 and lost a week’s worth of memory after a savage assault from her boyfriend. He was charged with attempted murder and later hanged himself in jail. He had repeatedly kicked her in the head and tried to strangle her because she had refused to have sex with him.

As a result of the head trauma, Lori developed hydrocephalus and had frequent headaches and dizzy spells. A couple of years before her hospitalization on the psychiatric ward, I had taken her to a neurologist in Toronto but it had been pointless. After a quick review of her MRI pictures and an in-office test, where she literally had to close her eyes and jump on one foot, the doctor declared that inserting a shunt to drain off the excess fluid on her brain wouldn’t relieve her symptoms. Fifteen minutes and we were out the door.

*****

Lori was released to go live in a long term care facility six weeks after Mother’s Day. She was the only resident who wasn’t a senior and she refused to take part in any of the activities. She hated it there and begged me to let her come home but nobody in the family could take care of her. Mom was 81 and not in good health and both my brother and I had our own families to care for.

Every day was filled with agitation. Lori had severe anxiety and all she wanted to do was smoke. She clutched the talking clock pendant that hung around her neck and checked the time obsessively because she was only allowed one cigarette per hour. But she kept asking for more. She had to be supervised outside for her safety and as soon as she got back to her room, she wanted to go smoke again, frantically begging whoever was in the room to take her outside. She didn’t remember the cigarette she had had five minutes before.

Still, there was nothing medically wrong with her. It was Adjustment Disorder but now combined with aggression and swearing. The staff at the long term care facility tried to modify her anti-social behaviour: if she swore she couldn’t have a cigarette. Not having the cigarette made her even more aggressive and one time she struck a resident with her cane, which meant another trip to the hospital, this time in the back of a police cruiser. She returned to the care facility a few hours later but nothing had changed. She kept asking for cigarettes over and over.

I tried to tell the staff that she couldn’t control her behavior. She wasn’t doing it on purpose and that taking away the only thing she enjoyed wasn’t getting them anywhere. I wished she had an Alzheimer’s diagnosis instead. At least then the medical community would be more patient because aggression is a common side effect of Alzheimer’s. If they would just treat her as if she had dementia, then they would know how to handle her. But without that official diagnosis on her chart they simply treated her as if she were a naughty child.

She was eventually kicked out of the care facility because of her aggression and hospitalized again until space could be found in a local group home. Two weeks after she arrived at the group home, a resident called the police because Lori was screaming and swearing. This meant another trip to the hospital where she stayed for a month until her psychiatrist finally agreed to send her to London for a second opinion.

I was so happy she was going to get the medical testing she needed to find out what was going on in her brain but my happiness was short-lived when I went to see her and discovered she was in a mental health centre, not a regular hospital.

“The people here are crazy,” she said. “One chick set her bed on fire. Another time she put a bag over her head.” We sat in the common area for the floor where she was staying. I wasn’t allowed in her room because of privacy concerns for the other patients. ”They put me in lock up for a day and a half. I couldn’t find the bathroom so I shit on the floor.”

I ignored the shitting on the floor comment. “So why were you in lock up?”

“Because I was yelling.” She ran her fingers through her short, wiry hair, her nails yellowed from too much smoking. “I know I’m not the same anymore! The doctor says I have brain damage. That’s awful.”

“How do you know he said that?” Lori was not a reliable narrator so I didn’t automatically believe what she told me.

“He looked at my last MRI and said I had a lot of brain damage from when I got beat up.” She started to cry. “I’ve got brain damage,” she sobbed.

“At least there’s a reason for why you’ve changed so much,” I said. “And there’s the hydrocephalus and the stroke too. It’s more than just the assault from Patrick, though. I think everything is connected.”

“Don’t say that asshole’s name,” she hissed. “I’d kill that fucker if I could. He got off easy but look at me! My brain is broken.”